Homestead_Smith (5) •
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER •
•
Vinod Gupta Owner
Preparer of the Sales Disclosure Form Tide
17962 Foxborough Lane
Address(Number and Street) Company
Boca Raton FL 33496 561-487-2742
City,State,and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTORO -
Vinod Gupta
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
17962 Foxborough Lane
Address(Number and Street) Address(Number and Street)
Boca Raton FL 33496
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Sgnawre of Seller Signature of Seller
Vinod Gupta "It- Aft ''die/ _- I to
Printed Nameo Seller Sign Dote MM DOWV Printed Name Seller ISM:LAE: a M 0W4
F.BUYFRIS,)/GRANTEE S -APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITE • THAT AP'is `-
"Erystal Smith 8 q
Buyer l-Name as appears on conveyance document Buyer 2-Name as appears on conveyance docurrkrl[-[[rr B 8 2018
428 N Lincoln St
Address(Number and Street) Address(Number and Street)
Oakland City IN 47660 if.
-
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION c Mn anMnmrty
0 ❑ 1.Will this property be the buyer's primary CY; ❑ 3. Homestead-D
residence? Provide complete address of primary ❑ 2 4.Solar Energy Heating/Cooling System
residence,including county: ❑
428 N Lincoln St 5.Wind Power Device
Address(Number and Street) ❑ ca 6. Hydroelectric Power Device
Oakland City IN 47660
City,stateZIPC de County ❑ EN 7.Geothermal Energy Heating/Cooling Device
EN
❑ 12 2.Does the buyer have a homestead in Indiana to be ❑ 8. Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ IN 9.Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail?(Provide contact information
including county: below.Please see instructions for more information.
Not available in all counties.)
Address(Number and Street)
-4 -iV-it- Yoi- boo . 009_007
City,State ZIP Code County
Primary property owner contact name E-mail